Risk scores are statistical indicators based on prescribing patterns compared to specialty peers. They are NOT allegations of fraud, misconduct, or improper care. Many legitimate medical reasons can explain outlier prescribing.
Read our methodology →🚫 This provider appears on the OIG List of Excluded Individuals/Entities (LEIE)
Exclusion type: 1128b4 · Date: 20250120 · State: CA
Risk Flags
Risk indicators are statistical patterns, not allegations. Learn more
304
Total Claims
$14K
Drug Cost
24
Beneficiaries
$569
Cost/Patient
Risk Score Breakdown 43/100
Score components are additive. Read full methodology
Peer Comparison vs. 7,389 General Practice providers
+1468%
Opioid rate vs peers
38.8% vs 2.5% avg
-50%
Cost per patient vs peers
$569 vs $1,128 avg
-45%
Brand preference vs peers
4.6% vs 8.4% avg
⚠️ This provider has metrics more than 3 standard deviations above their specialty average in one or more categories.
🔎 Data Overview
This provider appears on the federal OIG exclusion list, meaning they have been formally barred from participating in federal healthcare programs due to fraud, patient abuse, licensing issues, or other misconduct. The fact that they still appear in active prescribing data is a significant concern.
Opioid prescribing rate is 1,468% above the average for General Practice providers. While some providers legitimately treat pain-heavy populations, deviations of this magnitude are rare and warrant examination.
Insights generated from CMS data analysis. Statistical patterns are not accusations — always consider clinical context.
Opioid Prescribing
38.8%
Opioid Rate
118
Opioid Claims
$3,072
Opioid Cost
—
Long-Acting Rate
This provider's opioid prescribing rate of 38.8% is above the 20% threshold that CMS considers elevated.
Brand vs Generic
Brand: 14 claims · $5,933
Generic: 290 claims · $7,721
Patient Profile
62
Avg Age
—
Female
0.85
Avg Risk Score
Explore More
Data from CMS Medicare Part D Prescriber Public Use File, 2023. Risk scores are statistical indicators, not allegations.Methodology · About